improving referral communication in the mainehealth region
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Improving Referral Communication in the MaineHealth Region. Referral Communication Workgroup May 2002. MaineHealth Hospital Members /Affiliates. 1. Miles Healthcare 2. St. Andrews Hospital & Healthcare 3. Maine Medical Center 4. Spring Harbor Hospital 5. Western Maine Healthcare - PowerPoint PPT PresentationTRANSCRIPT
MaineHealth
Improving Referral Communication in the MaineHealth Region
Referral Communication Workgroup
May 2002
MaineHealth
MaineHealth Hospital Members/Affiliates
1. Miles Healthcare
2. St. Andrews Hospital & Healthcare
3. Maine Medical Center
4. Spring Harbor Hospital
5. Western Maine Healthcare
6. Southern Maine Medical Center
7. Mid Coast Hospital
8. MaineGeneral Health
9. Sisters of Charity Heath System
MaineHealth
MaineHealth Vision
Working together so our communities are the healthiest in America.
MaineHealth
A s th m a C a rd io va scu la rH e a lth
D ia be tes ReferralCom m unication
W o m e n 'sH e a lth
D e p ress ion
C lin ica lIn teg ra tio n S te ering
C o m m ittee
M H M a n a g em e ntT e am
M H B o a rd o f T rus te es
MaineHealth Decision-Making Structure as related to Clinical Integration
MaineHealth
The Problem
A recent physician survey and review of
medical literature show that there is
significant need to improve the exchange of
clinical information when a patient is
referred for specialty consultation.
MaineHealth
The Problem for PCP’s• 45% of PCP’s reported that they do not
receive appropriate follow-up information from specialists after a referral.
• 12% are “very satisfied” with the information they currently receive.
• Only 8% are satisfied by their current ability to book patients in an acceptable period of time.
MaineHealth
The Problem for Specialists
• 68% of specialists reported that they do not receive adequate clinical information on patients referred to them.
• 1% were “very satisfied” with the information they are currently receiving.
MaineHealth
Causes and Effects of Poor Communication
• It’s difficult to access patient information: it comes from different sources (e.g. lab, imaging)
• Physicians may be unaware of the problems
• Practices already face heavy administrative demands
• Provider dissatisfaction
• Patient dissatisfaction
• Practice inefficiencies, redundant testing, wasted resources
MaineHealth
Solutions
Clinical Integration Steering Committee
formed a Referral Communication
Workgroup (RCW) to address these issues
and to propose potential solutions.
MaineHealth
Referral Communication Goals
Promote quality patient care, improve
efficiency, and improve provider and
patient satisfaction by cultivating
relationships and supporting effective
communication between PCP’s and
specialists.
MaineHealth
Referral Communication Efforts• Identify current “best practice” groups that
demonstrate excellent specialist/PCP relationships and communication.
• Develop recommended standards to help build PCP-specialist relationships.
• Develop recommended clinical communication standards for both PCP’s and specialists when making specialty referrals.
MaineHealth
Referral Communication Efforts
• Develop practical office-based tools to improve clinical communications.
• Identify pilot sites to test ways to improve communication processes. Measure outcomes and refine recommendations and tools.
MaineHealth
Office-based Tools
• Referral etiquette - PCP and Specialist relationships
• PCP Guidelines
• Specialist Guidelines
MaineHealth
PCP Guidelines
• Clarity regarding reason for referral
• Clarity regarding timing/urgency of referral
• Transfer of background information before the appointment
• Co-management expectations
MaineHealth
Specialist Guidelines
• Office system in place for emergent/urgent consultation requests
• Timely communication of information back to PCP- Quick FAXback form for emergent/urgent consultations, all within 1 week
• Co-management recommendations
MaineHealth
Office-based Tools
• PCP request for specialty consultation
• Quick FAXback form -brief handwritten information pending full report
• Specialty consultation follow-up form
MaineHealth
Referral Communication Forms
• May be personalized and customized by practices
• Utilize key features to achieve standardization in referral communications in our community
MaineHealth
Pilot Site Interventions
• PCP sites– GPMG Westbrook
– GPMG Spurwink
– Intermed Longcreek
– Scarborough Family Practice
• Specialty sites– Maine Neurosurgery
– Orthopaedic Associates
– Portland GI
MaineHealth
Pilot Site Results
12 of 15 participating PCP’s and staff agreed or strongly agreed that using referral communication form…
– Helps ensure correct information is sent when referring patients to specialists
– Improves efficiency of sending clinical info when making a referral
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Pilot Site ResultsReferral communication form helpful because…• “It takes the guesswork out of the diagnosis”• “Everything needed is on one form”• “Making appointments is easier”• “Appropriate diagnosis information and test or consult
very well defined”• “Uniform method of assuring appropriate info gets sent” • “ It speeds up the process”• “Easy to use”
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Pilot Site Results
Specific ways communication form has helped my practice…
• “Helped to make appointments easily”• “Great for clinical and referral staff”• “Appointments can be made and referrals in smooth
and organized manner”• “Helps to catch possible missed steps”• “Assures proper information gets sent” • “All the doctors need to use these forms”
MaineHealth
RCW Implementation Plan• Presentation of tools
– Medical Staffs– PCP and Specialty Groups
• Provision and utilization of tools– Download from floppy disc– Web-based access (www.mainehealth.org)
• Best Practice Awards as recognition for compliance
• Revision of tools/upgrades
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“Best Practice” Recognition
• Internal survey tool
• Internal audit
• External validation
• Rewards and recognition– Staff lunches or theatre tickets– Publications, e.g. hospital newsletters– Best Practice plaque for waiting room
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The Old Way• Frustration about getting timely
consultation
• Patients arrive for consultation with inadequate background information
• Variation in getting timely information back to the PCPs by the specialists
• Specialists assume co-management responsibilities without PCP approval
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The New Way• Specialist office systems to accommodate all
consultation requests, even emergent/urgent
• Full background information available before patients is seen by consultant
• Timely return of information from specialist back to PCP
• Clear communication about shared co-management responsibilities between PCPs and specialists
MaineHealth
MaineHealth Vision
Working together so our communities are the healthiest in America.